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The Thought-Experiment: Shewmon on Brain Death

1992; Pontifical Faculty of the Immaculate Conception; Volume: 56; Issue: 3 Linguagem: Inglês

10.1353/tho.1992.0019

2473-3725

Andrew Tardiff,

Medieval Philosophy and Theology

THE THOUGHT-EXPERIMENT: SHEWMON ON BRAIN DEATH 1 ANDREW TARDIFF University of Rhode Island Kingston, Rhode Island MODERN TECHNOLOGY as it advances often brings with it new ethical problems. One such problem is "brain death." In times past, that is, up until the 1960s, medical men considered cardiopulmonary collapse as the criterion for the death of the person, for with heart failure the body ceases to function as a whole living organism. As technology and science advanced, however, scientists discovered that when the heart failed the very first organ to be irreparably damaged was the brain. Moreover, around this time they discovered how to revive the heart and to keep the body alive even after the brain had been destroyed. These discoveries and advances alone might not have sufficed to raise the issue of brain death. But science also discovered the crucial role the brain plays for consciousness and a fortiori for the specifically human abilities of knowing and willing. It is thus that we now have the question : once the brain has been irreparably damaged, and the possibility of consciousness and personal life thereby excluded, is such a person really dead, even though his body is alive and functioning? But it would be less than honest to say that this is an adequate history of the brain death criterion. For with the dawn of organ transplantation a new demand for living organs arose, one that had never been known before. Under the old cardiopulmonary criterion of death, the demand for living organs could not be met since the organs of a person " dead " in that sense of the word 1 " The Metaphysics of Brain Death, Persistent Vegetative State, and Dementia ", The Thomist, 49 (January, 1985) : 24-80. 435 436 ANDREW TARDIFF could not be transplanted; under the brain death criterion they could. Such a situation will quite naturally give rise to, or at least heavily contribute to, a less than objective handling of the issue. Happily, however, the literature on brain death has recently seen a serious objective appraisal of the issue: D. Alan Shewmon 's article The Metaphysics of Brain Death, Persistent Vegetative State, and Dementia. Shewmon argues persuasively that the new criterion of death is sound. He argues for an exact formulation of the criterion of the death of the person, viz., the death or irreparable destruction of one specific part of the brain, namely, the tertiary cortex. Thus, the death of the person occurs with the irrevocable destruction of the tertiary cortex, even if the rest of the body is still functional. In the following pages I will consider Shewmon's analysis of the issue and expose some of the major problems with his arguments . My critique will focus chiefly on an analysis of a certain thought-experiment of which Shewmon makes extensive use. I do this both because of its central role in Shewmon's argument and because of the light it sheds on the whole problem of using brain death as the criterion for the death of the person. The Thought-Experiment Shewmon has set out to show that only the teritary cortex is the critical structure or formed matter necessary for the human essence.2 In a later passage, however, he mitigates this claim slightly, in case science should someday discover that some other area (or just some fraction of this area) is the critical area.3 But in either case, Shewmon maintains that the crucial area is to be found in the neocortex of the cerebral hemespheres. By the time his analysis has reached page fifty-nine, he believes he has established this much. The following is an examination of his thoughtexperiment and how he establishes the above claim. Shewmon begins with certain observations about how the human essence relates to the various parts of the body. Modern 2 Ibid., p. 56ff. a Ibid., p. 59. SHEWMON ON BRAIN DEATH 437 technology has developed ways to remove parts of a man's body without killing either the man or the part. Science can remove a person's kidney, for example, and transplant it into another person 's body without killing either the person or destroying the living cells of the kidney. Moreover...